At one time revulsive, derivative and counter irritating agents were used very commonly. There is no doubt but they were used too frequently, and too actively, but properly used they exercise in selected cases a most excellent influence, and their use is now apt to be overlooked. Among the commonest of these was cupping. Wet cups are seldom if ever needed, but dry cups are harmless, and often immediately and actively beneficial. It seems impossible to those of us who are older, that the younger physicians should know so little of this method, although it is not usually mentioned in the college course.
There are two conditions in which I have found dry cupping of immediate and permanent benefit. These are where there is spinal irritation-deep soreness over the spinal cord or over the ganglia with the long train of nervous symptoms which are apt to follow this condition. The other is backache in the region of the kidneys of a distressing and more or less permanent character. When this condition is persistent during the course of chronic kidney disease, I have found cupping to assist very materially in the treatment of the kidney disorder. It is of immense service in nephritis.
I have found this method serviceable also in the treatment of congestive headache, the cups being applied at the nape of the neck; also in chronic liver disorder and in pelvic derangements which are accompanied by constant more or less severe pain in the sacral regions.
In applying dry cups, an ordinary tumbler may be used or a small cupping glass. These are of thick glass with smooth edges, thin glass cups, while the vacuum is produced more quickly may break with laceration of the skin. The surface to be cupped should be moistened with warm water. Three or four drops of alcohol should be dropped into the bottom of the glass when the surface is prepared, ignited and the glass immediately inverted and pressed against the moistened skin, while the alcohol is still burning, care being taken that there is not enough alcohol to run down upon the skin while burning.
Immediately the glass is pressed against the surface, the flame is extinguished and the glass cooling, a vacuum is formed, and the structures beneath the glass are pressed upward into the vacuum in a convex form. The skin included, fills very rapidly with blood, the capillaries becoming greatly distended. I have found a small glass, one the top of which has the diameter of about two inches, to be the best size. Larger than this it is more difficult to handle.
The glass will remain on until the pressure abates from the return of air within the glass, but usually a physician must decide for. each case, how many glasses should be applied, and how long they should remain on. I have frequently produced fainting and nausea with a single glass. These symptoms should not cause the glass to be withdrawn. The patient should lie prone and may drink a little cold water. From three to six glasses may be applied at once under proper circumstances and may remain on from four to twelve minutes.
When the area within the glass becomes greatly discolored or discolors rapidly I have made it a point, either to admit a little air by pressing some smooth steel object under the edge of the glass, as the handle of a key, or by thus removing the glass entirely. Their application may be repeated every two, three or four days, according to the severity and progress of the case.
Wet cups refer to the withdrawal of a small quantity of blood by scarifying the skin before the cup is applied.